YOGA THERAPY BOOKS BY Kate

About 50% of the population will suffer from a mental disorder at some point in their lives. Luckily, yoga therapy is very appropriate for thes e problems; technically there is no limit to what psychological problem yoga can treat. This is due to neuroplasticity - the brain's ability to reorganize itself by forming new neural connections throughout life. Changes in neural pathways and synapses occu r due to changes in behaviour, environment, neural processes, thinking, emotions, as well as changes resulting from bodily injury. Yoga is ideally suited to change neural pathways because it effects changes on so many of these levels.

For instance, anxiety is not a direct response to an event, but rather a reaction because a certain neural pathway was triggered. You see something (a snake), this triggers a memory (snake = deadly), which then triggers a fear response. Primal emotions such as fear are control led by the amygdala (‘reptile brain’); there are good evolutionary reasons that we have them. However, the pathways which trigger these emotions can be modified. This means that you can create new neural links that create anxiety even though it’s not the a ppropriate response.

Neural pathways are created via neurotransmitters in the brain, the key ones being serotonin, norepinephrine (a type of adrenaline), dopamine and GABA. Adrenaline gets released by the adrenal gland but also by the brain itself. In addi tion, some other substances can cross the blood/brain barrier - including caffeine, nicotine, alcohol and drugs. This is how people become addicted. A neurochemistry imbalance leads to mental imbalance. Yoga helps restore neurochemical balance.

What is a mental disorder or abnormal behaviour?

One key characteristic is maladaptive behaviour - Adaptive behaviour is a type of behaviour that is used to adjust to another type of behaviour or situation. These behaviours are most often social or personal. Maladaptive behaviour is a type of behaviour that is often used to reduce one's anxiety, but t he result is dysfunctional and non - productive. Maladaptivity is frequently used as an indicator of abnormality or mental dysfunction, since its assessment is relatively free from subjectivity.

For example, in Obsessive - Compulsive Disorder, one develops a behaviour (compulsion) to distract from an unpleasant recurring thought (obsession) e.g. washing hands whenever they want to hurt someone. This creates a neural pathway linking the thought and behaviour. Yoga works on breaking this link by helping to chang e the neural pathway.

Pain or discomfort - Suffering of some sort is a key feature of psychological problems. Though the person may not be aware that there is something wrong with them, they do experience mental or physical ill effects.

Deviancy / Violation of standards of society - Behaviour that is not expected and/or accepted in the sufferer’s surroundings, which leads to further problems as they withdraw and lose touch with society.

Social discomfort - Inability to feel calm and at ease in social situatio ns, which usually leads to avoidance and further problems.

The upshot is that with psychological problems, quality of life is affected to some degree in all spheres of functioning (social, work, family). This is why personality disorders are controversial; many do not accept that they should be included as psychological problems because people do not experience suffering, social discomfort etc. - it’s mainly other people who experience any ill effects!

It is important to note that stress is not inherently ba d. We need stress sometimes, so that we take action or make a change. Stress increases efficiency, partly due to the physiological changes it induces, partly due to our response to it. However, sometimes stress increases but efficiency does not increase (e .g. we do nothing or panic) which can lead to further stress. According to yoga, when you feel peaceful within, you react peacefully so the aim is to develop the right attitude - not to avoid stress.

In a similar way, being anxious or depressed are also no t inherently bad. They are signals that something needs to be addressed or changed. We have become increasingly intolerant of negative emotions, instead of dealing with them appropriately. In fact it is our intolerance to them that creates problems - we pus h away or suppress, which doesn’t work.

Types of disorders

According to DSM – IV’s definition of mental disorders the following components are considered necessary for diagnosis

• Clinically significant behavioural or psychological pattern
• Associated with distress or disability (in one or more important areas of functioning)
• Not simply a predictable response to an event (death of loved one)

Anxiety disorders

Anxiety – response to internal, unknown, vague and conflictual threat whilst fear is a response to an external, definite or non - conflictual threat. (Conflictual = the arousal of two or more strong motives that cannot be solved together.) Anxiety is characterised most commonly as a diffuse, unpleasant, vague sense of apprehension, often accompanied by autonomic symptoms such as headache, perspiration, palpitations, tightness in chest, mild stomach discomfort and restlessness,

Involves negative mood, worry about fu ture threat or danger, difficulty concentrating, irritability and at physiological level creates a state of tension, sleep disturbance and chronic over arousal of flight or fight response.

Phobias – Specific, Social

Panic attacks (with or without Agorapho bia) – palpitations, sweating, trembling, shortness of breath, feeling of choking, chest pain, abdominal distress, feeling dizzy, lightheaded or faint, derealisation or depersonalization, fear of dying or going crazy, chills or hot flashes

• Generalized Anxiety Disorder
• Obsessive Compulsive Disorder

When anxiety is constant or overwhelming and interferes with relationships and activities, it stops being functional. The fight or flight response is activated by a thought rather than actual danger. The medical view is a serotonin imbalance so they prescribe anti - anxiety medication (sedatives) or SSRIs. These only further mess up the brain’s neurochemistry without addressing the cause. Other therapies include behaviour and exposure therapy.

Mood disorders

Mood – pervasive and sustained feeling tone that is experienced internally and that influences person’s behaviour & perception of the world

Depression – depressed all day, diminished interest in almost all activities, weight loss or weight gain, insomnia or hyp ersomnia, fatigue or loss of energy, feeling of worthlessness or guilt, difficulty concentrating, indecisiveness, thoughts of death or suicide

Bipolar - Depression with periods of mania. A manic episode is an abnormally and persistently expansive, elevate d or irritable mood, inflated self - esteem, decreased need for sleep, more talkative, flight of ideas or thoughts racing, distractibility, increase in goal directed activity

Suicide - Thoughts of suicide are a key feature and there is a significant risk of s uicide in severe cases.

Physiological causes of anxiety & depression include neurotransmitters imbalance (serotonin, norepinephrine, GABA, dopamine) or hormonal imbalance (due to chronic arousal to sympathetic nervous system or failure of negative feedback loop between HPA axis.) Medical treatments options include antidepressants, mood stabilizing drugs, anti - psychotic drugs, ECT, TMS, bright light therapy. The best way to reduce the need for medication is through a yogic lifestyle.

Schizophrenia & other p sychotic disorders - severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone i s plotting against you or that you rule the world. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there.

Somatoform disorders - When mental factors such as stress cause physical symptoms the condition is know n as somatization. The symptoms can't be traced back to any physical cause and are not the result of substance abuse or another mental illness. People with somatoform disorders are not faking their symptoms. The pain and other problems they experience are real. The symptoms can significantly affect daily functioning.

Fibromyalgia is not considered somatoform because the nervous system shows a measurable increased response to pain. In this condition yoga can also bring relief, as for anxiety asanas should be built up over time.

Dissociative disorders - Dissociative identity disorder (formerly multiple personality disorder); Dissociative amnesia; Depersonalization disorder (periods of detachment from self or surroundings).

Impulse control disorders - can’t resis t the urge to do something harmful to themselves or others (this is often a feature of other disorders too, especially substance misuse) e.g. addictions, eating disorders, compulsive gambling, compulsive hair pulling, stealing, fire setting, intermittent explosive attacks of rage.

Substance related disorders - Harmful overuse of alcohol, caffeine, nicotine, opium, cocaine, amphetamines, LSD & other narcotics. Sub - categories are Substance Dependence Disorder and Substance Abuse Disorder.

Eating disorders - Severe disturbance in eating behaviour. 70% of people with eating disorders also have depression. Psychologically it is due to fear of isolation or not being socially acceptable. Other causes include socio - cultural factors, media influence, family influe nce, body dissatisfaction and dieting.

Anorexia nervosa – distorted perception of body shape and size, intense fear of gaining weight even though underweight

Bulimia nervosa – binge eating and efforts to prevent weight gain using self induced vomiting, excessive exercise, use of laxatives

Sleep disorders - excessive sleep, insomnia, nightmares, night terrors, bedwetting, teeth grinding etc.

Others

Learning disorders – reading d isorder, writing disorder (dyslexia), mathematics disorder

ADHD – Attention Deficit Hyperactivity Disorder

Autism – characterized by absence of communication, social interaction and repetitive behaviour

Mental retardation - IQ below average and in between 2 5 to 90 which affects the daily functioning significantly.